Save Our Skin Award Recipients

Teams that prevented pressure ulcers in a patient at high-risk for pressure ulcers

Length of Stay / Innovative Practices/Implementations
+14 days /
  • Heel Elevations
  • Regular repositioning
  • Placed on a rotation bed w/documentation of head of bed less than 30 degrees.
  • Use of non petroleum based barrier cream around the multiple drains to keep skin intact
  • Dressing changes up to every two hours

94 Days /
  • Consistent Core group of Nurse caregivers
  • Immediate attention to diaphoresis and hyperthermia during the sympathetic storms providing medications, linen changes and cooling
  • Attention to posturing, rigidity and head turning
  • Consistent and timely repositioning
  • Pressure redistribution mattress
  • Regular skin assessments
  • Collaboration with unit based clinical Nurse Specialist for care planning
  • Collaboration with dietitian to meet nutritional needs
  • Physical therapy participation with positioning, range of motion exercises and strengthening throughout his recovery
  • Education involvement and support of family

Unknown /
  • Pressure redistribution chair cushion
  • Dietary supplements TID along with meals
  • Miconazole Nitrate 2% powder applied to skin folds to treat yeast and intertrigo
  • Aggressive diuressis to decreases peripheral edema
  • Bedside commode used until Foley catheter needed for increased dieresis/UOP
  • Tubigrip compression Stockings applied after initial dieresis to manage lower leg edema

55 Days /
  • Repositioning
  • Worked closely with the Dietician and diabetes educator
  • Educating family
  • Trialed skin products

>90 days /
  • Adherence to pressure relieving tactics such as strict every 2 hour turning
  • Nutritional Needs
  • Music Therapy – Helped motivate the patients to move
  • Positive reinforcement and jubilant cheerleading to encourage patient participation

>40 days /
  • Using ceiling lifts
  • The right skin products
  • High frequency of vigilance and using baby moves – just a hint of movement every 15 minutes to slowly reposition the patient.

20 Months /
  • Assessed Braden Q score daily
  • Outlined plans for frequent repositioning
  • Minimizing shear when agitated
  • Elevating ankles/feet
  • Frequently checking bony prominences for signs of skin breakdown
  • Maximizing nutrition
  • Consistent core group of nurses
  • Changed clothing, bed-linen and provided skin hygiene as needed, (up to 3x daily)
  • Family participation

91 Days /
  • Continuous Lateral rotational bed
  • Repositioning ever 2 hours
  • Arms and Legs supported on pillows, podus heel lift boots were on and off ever 2 hours
  • Mepilex sacral boarder dressing was applied
  • Daily baths with chlorhexidine and moisturized
  • Core nursing staff
  • 1:1 or 2:1 nursing ratios
  • Family assisted with care

60 Days /
  • Expert low air loss mattress and rotation therapy
  • Meticulous pericare w/flexiseal device for fecal containment
  • Skin protectant and barrier spray after each cleansing
  • Astute skin assessment with associate devices and assurance for proper repositioning or removal of devices
  • Passive range of motion
  • Routine oral care
  • Ceiling lift
  • Skin inspection every 2 hours
  • Pain management and comfort promotion to enhance coughing, movement, comfort and inflammatory responses
  • Scalp massage with every turn to promote circulation to the scalp
  • Body Diagram document
  • Pillow repositioning and z-flo cushion trail to address bony prominence areas
  • Diligent skin hygiene w/ daily baths

+70 days /
  • Coordinated care with wound ostomy nurses, neurosurgery and orthotists to appropriately measure /document all wounds
  • Create wound care plan
  • Modified halo to adjust the pressure points
  • Educating family and patient
  • Scheduled both rehab sessions and would care time
  • Wound care nurses worked with patient on plans that the patient could tolerate

Unknown /
  • Low air loss bed
  • Repositioned with fluidized positioners
  • Heels floated
  • Wicking silver fabric interdy Ag was used to manage moisture in skin folds
  • Clinical educators helped educate staff and provide educational resources for nurses
  • Breathable under pads were placed over the low air loss bed
  • Critic Aid Clear Ointment was used
  • Skin washed with neutral PH cleanser
  • Family support and educated

24 days /
  • Frequent repositioning
  • Involved WOC Nursing
  • Protective dressing applied
  • Family support and educated
  • Ceiling lift equipment to transfer patient to chair to reduce time spent lying in bed

104 days /
  • Implemented pressure ulcer prevention care plan
  • Routine turning schedule
  • Heel lift boots
  • Roho seat cushion utilized when up to chair
  • Pillows to elevate arms
  • Weekly massages were done
  • Provide moisture treatments with lotion
  • Pain management schedule was implemented
  • Nutritional support from unit dietician

30 days /
  • Evaluation and selection of sleepwear
  • Electronic monitoring electrodes
  • Bedding and positioning supports
  • Mattresses
  • Use of Neonatal skin condition score ever 4 hrs
  • Full body skin assessment every 24 hours
  • Re-positioning or off-loading pressure every 1-4 hours
  • Access to electronic skin assessment and care guidelines

60 days /
  • Consistent/timely repositioning
  • Frequent communication between nursing/patient and family
  • Appropriate pain management to increase patient comfort
  • InterDry Ag dressings
  • Barrier products to help minimize friction
  • Use of air mattress utilized to minimize moisture exposure
  • Collaboration w/Clinical Nurse Specialist for care planning
  • Chaplain and psychiatry to help w/depression
  • Collaboration w/physical therapy